Conclusions

Among patients with out-of-hospital cardiac arrest, randomization to a strategy of advanced airway management with a supraglottic airway device compared with tracheal intubation did not result in a favorable functional outcome at 30days.

Conclusions

Among adults with OHCA, a strategy of initial LT insertion was associated with significantly greater 72-hour survival compared with a strategy of initial ETI. These findings suggest that LT insertion may be considered as an initial airway management strategy in patients with OHCA,

Strength:

This is a well conducted study with a large population that investigated a relevant clinical topic.

Limitations:

In the TI group the first passage success rate is particularly low (51%) and there is no mention on the percentage of reintubation. This makes the neurologic outcome of this group particularly subject to procedural bias.

In general there is no mention of the post resuscitation care protocol and we know how this period is important on neurological outcome and individual variation makes bias very likely on this particular end point.